Unknown Individual – Adult Health Nurse Practitioner, NPI 1013966688

Unknown Individual is a healthcare provider. based in Deland, Florida. specializing in Adult Health Nurse Practitioner. They hold a License No. 73965 (MA). The NPI Number for Unknown Individual is 1013966688

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1013966688
Phone
(386) 734-0121
Address
112 E NEW YORK AVE
Deactivation Date
14 June 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 112, East New York Avenue, DeLand, Volusia County, Florida, 32724, United States

    SUITE E

    DELAND, FL 327245504

    Phone: (386) 734-0121

    Fax: (386) 734-0332

    Type: Location

  • 6, Aucuba Circle, Ormond Beach, Volusia County, Florida, 32174, United States

    ORMOND BEACH, FL 321741494

    Phone: (386) 676-0062

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32724)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1013966688 — is the standard way to identify this listing.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Adult Health Nurse Practitioner is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Deland, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
2 practice locations appear in the available data.